Predictors of in-hospital mortality in patients admitted to the
emergency department with cardiogenic pulmonary edema
Abstract
Background: Despite significant advances in the treatment of heart
failure, the prognosis of acute cardiogenic pulmonary edema (ACPE)
continues to be a serious problem. The objective of this study is to
determine the risk factors affecting in-hospital mortality in patients
with ACPE. Methods: We enrolled 305 patients who were hospitalized with
cardiogenic pulmonary edema as a diagnosis. Clinical, biochemical and
echocardiographic variables were collected and analysed. The patients
were divided into two groups according to the presence of mortality.
Both groups were evaluated in terms of clinical features during
admission to the emergency department (ED) and factors affecting
in-hospital mortality. Results: Forty-two patients died and the
mortality rate was 13.8%. To determine the factors affecting mortality,
multiple logistic regression analysis was performed. In the regression
analysis, it was seen that age at admission to the ED (OR:1.75, 95% CI
1.18-3.05, p:0.014), systolic blood pressure (OR:0.95, 95% CI
0.31-0.98, p:0.040), presence of acute myocardial infarction (OR:4.17,
95% CI 1.85-7.13, p:0.001), positive troponin (OR:5.47, 95% Cl
1.07-7.46, p:0.011), atrial fibrillation rhythm (OR;3.16, 95% CI
1.81-8.02, p:0.010), inotropic drug usage (OR;5.61, 95% CI 1.87-9.24,
p:0.013) increased in-hospital mortality. Conclusion: Our findings might
help clinicians in identifying patients with poor prognosis early in the
presence of identified risk factors.